WAC 182-543-4000. Covered—Wheelchairs—General

(1) The medicaid agency covers, with prior authorization, manual and power-drive wheelchairs for clients who reside at home. For clients who reside in a skilled nursing facility, see WAC 182-543-5700 . (2) For manual or power-drive wheelchairs for clients who reside at home, requests for prior authorization must include all of the following completed forms: (a) General Information for Authorization form (HCA 13-835). The agency's electronic forms are available online (see WAC 182-543-7000 , Authorization); (b) A Prescription Form (HCA 13-794); and (c) Medical Necessity for Wheelchair Purchase (for home clients only) form (HCA 13-727) from the client's physician or therapist. The date on this form (HCA 13-727) must not be prior to the date on the Prescription Form (HCA 13-794). (3) The agency does not pay for manual or power-drive wheelchairs that have been delivered to a client without prior authorization from the agency. (4) When the agency determines that a wheelchair is medically necessary, according to the process found in WAC 182-501-0165 , the agency rents or purchases a wheelchair for clients who live at home. For clients who reside in a skilled nursing facility, see WAC 182-543-5700 .